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儿童胆总管囊肿:临床表现与预后——来自巴基斯坦一家三级医疗中心的10年经验

Choledochal Cyst in Children, presentation and outcome - 10 years' experience from a tertiary care center in Pakistan.

作者信息

Farooq Muhammad Arslan, Khan Sabeen Abid, Malik Munir Iqbal

机构信息

Dr. Muhammad Arslan Farooq, MBBS, FCPS (Pediatrics). Senior Registrar, Pediatrics, Shifa Tameer-e-Millat University (Shifa College of Medicine)/ Shifa International Hospital, Islamabad, Pakistan.

Dr. Sabeen Abid Khan, MBBS, FCPS (Pediatrics). Associate Professor, Pediatrics, Shifa Tameer-e-Millat University (Shifa College of Medicine)/ Shifa International Hospital, Islamabad, Pakistan.

出版信息

Pak J Med Sci. 2023 Mar-Apr;39(2):456-459. doi: 10.12669/pjms.39.2.6196.

Abstract

OBJECTIVES

This study was done to compare the clinical features, laboratory findings and surgical outcomes of pediatric patients with choledochal cysts.

METHODS

Retrospective review of the hospital records of all pediatric patients admitted with choledochal cysts from 2011 to 2021 were collected and analyzed. Patients were divided into two groups; infant (less than one year age) and pediatric (1 to 16 years) for statistical comparison of two groups.

RESULT

The study included 34 children, 9 (26.5%) were infant (<1 year) and 25 (73.5%) were more than one year old. Mean age at diagnosis was 15 months with age ranging from 14 days to 16 years. Females were 19 (55.9%) and males were 15 (44.1%). Type-I choledochal cyst was the most common (73.5%), presentation followed by Type-IVA (26.5%) in our patients. Patients from infant group presented with jaundice in 7 (77.7%), and clay-colored stool in 3 (33.3%) as the most common clinical features, while abdominal pain (88%), vomiting (72%), fever (32%) and pancreatitis (32%) were the frequent presentations among older age group. Post-surgical complications of excision of choledochal cyst were observed in 4 (11.7%) patients.

CONCLUSION

Choledochal cysts have variable presentations depending upon age of the patients. Complete surgical excision of choledochal cyst is the treatment modality of choice and timely surgical management can prevent complications.

摘要

目的

本研究旨在比较胆总管囊肿患儿的临床特征、实验室检查结果及手术效果。

方法

回顾性收集并分析2011年至2021年期间所有因胆总管囊肿入院的儿科患者的医院记录。将患者分为两组,即婴儿组(年龄小于1岁)和儿童组(1至16岁),以便对两组进行统计学比较。

结果

该研究纳入34名儿童,其中9名(26.5%)为婴儿(<1岁),25名(73.5%)年龄超过1岁。诊断时的平均年龄为15个月,年龄范围为14天至16岁。女性19名(55.9%),男性15名(44.1%)。I型胆总管囊肿最为常见(73.5%),其次是IVA型(26.5%)。婴儿组患者最常见的临床特征为黄疸(7例,77.7%)和陶土样便(3例,33.3%),而腹痛(88%)、呕吐(72%)、发热(32%)和胰腺炎(32%)是大龄组患者的常见表现。4名(11.7%)患者观察到胆总管囊肿切除术后的并发症。

结论

胆总管囊肿的表现因患者年龄而异。胆总管囊肿的完全手术切除是首选的治疗方式,及时的手术管理可预防并发症。

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1
Spectrum of acute, recurrent and chronic pancreatitis in children.
J Pak Med Assoc. 2020 Dec;70(12(B)):2412-2415. doi: 10.47391/JPMA.540.
3
Choledochal Cyst And Biliary Stone.胆总管囊肿与胆石症
J Ayub Med Coll Abbottabad. 2018 Jan-Mar;30(1):127-129.
5
Pediatric choledochal cysts: diagnosis and current management.小儿先天性胆管囊肿:诊断与当前治疗方法
Pediatr Surg Int. 2017 Jun;33(6):637-650. doi: 10.1007/s00383-017-4083-6. Epub 2017 Mar 31.
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Diagnosis and management of choledochal cysts.胆总管囊肿的诊断与管理
Indian J Surg. 2012 Feb;74(1):29-34. doi: 10.1007/s12262-011-0388-1. Epub 2011 Dec 10.
10
Role of laparoscopy in treatment of choledochal cysts in children.腹腔镜检查在儿童胆总管囊肿治疗中的作用。
Pediatr Surg Int. 2013 Apr;29(4):317-26. doi: 10.1007/s00383-013-3266-z. Epub 2013 Jan 31.

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